Oral Surgery · single question
A patient has a partially erupted mandibular left third molar with pain and red, swollen overlying gingiva. Which of the following would you NOT do?
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Correct answer: C. Prescribe an antifungal agent
- A. Definitive treatment is removal of the third molar once acute inflammation subsides, or extraction of the opposing tooth if it is the source of trauma. Operculectomy is an option in selected cases.
- B. Irrigation under the operculum with saline or chlorhexidine to flush debris is the first-line local measure.
- C. CORRECT — this is not indicated. PERICORONITIS is a BACTERIAL infection of the tissue overlying a partially erupted tooth, driven by anaerobes trapped under the operculum along with mechanical trauma from the opposing tooth. Antifungals have no role — there is no Candida infection here.
- D. Antibiotics (penicillin VK or metronidazole; clindamycin if allergic) are appropriate when there is fever, lymphadenopathy, trismus, or spreading swelling. Mild localized cases may need only local measures.
Note: Watch for trismus and dysphagia — pericoronitis can progress to submasseteric or pterygomandibular space infection.